Provider Demographics
NPI:1750881827
Name:BOZINOS, JAMES ERNEST (PSYD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ERNEST
Last Name:BOZINOS
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 COOPER ST
Mailing Address - Street 2:
Mailing Address - City:BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11702-2934
Mailing Address - Country:US
Mailing Address - Phone:631-661-6730
Mailing Address - Fax:
Practice Address - Street 1:51 COOPER ST
Practice Address - Street 2:
Practice Address - City:BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11702-2934
Practice Address - Country:US
Practice Address - Phone:631-661-6730
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-15
Last Update Date:2018-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017365103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist